fran kaufman tudiabetes cgm

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Medtron ic Diabetes 1 The Use and Future Use of Continuous Glucose Monitoring Francine Ratner Kaufman, M.D. Distinguished Professor Emerita of Pediatrics and Communications, The Keck School of Medicine of the University of Southern California Center for Diabetes and Endocrinology, Children’s Hospital Los Angeles Chief Medical Officer of Medtronic Diabetes Los Angeles, CA

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Dr. Francine Kaufman on CGM, presented live on TuDiabetes.com

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  • 1.The Use and Future Use ofContinuous Glucose Monitoring Francine Ratner Kaufman, M.D. Distinguished Professor Emerita of Pediatrics and Communications, The Keck School of Medicine of the University of Southern CaliforniaCenter for Diabetes and Endocrinology, Childrens Hospital Los AngelesChief Medical Officer of Medtronic DiabetesLos Angeles, CAMedtronic 1Diabetes

2. Meet Dr. Kaufman To register for a free copy of Insulin Pumps and Continuous Glucose Monitoring: A Users Guide to Diabetes Management, visit: http://info.medtronicdiabetes.com/ 2013-tudiabetes.htmlMedtronic 2Diabetes 3. CGM Completes the PictureFingerstick A1CTestingCGMTodays diabetes management requires comprehensiveunderstanding of glucose control. Medtronic3Diabetes 4. More Information MORE DATAwith Continuous Glucose MonitoringNUMBER OFCONTINUOUSGLUCOSEREADINGS PER105,120 YEAR(288 per day x 365days) NUMBER OF FINGERSTICK MEASUREMENTS PER1,460YEAR (4 per day x 365 days) Medtronic 4Diabetes 5. Continuous Glucose Monitoring Technology: Personal Use Personal CGM Paradigm and Guardian For use by people with insulin-dependent diabetes Real time displays of glucose values and trend graphsAllows You to Proactively Retrospective data through CareLinkRespond to Changes inYour Glucose Levels to Improve Control Real time CGM reveals fluctuations in your glucose levels that you cant see through A1C tests alone*. Medtronic 5Levetan C, et al. Diabetes Care 2003; 26:1-8 Diabetes 6. Site Differences in Glucose Testing: Interstitial Versus CapillaryMeter Sensor mirrors its Sensor and meter arereading to matchtesting at differentmeter: a process called SensorsitescalibrationSkin Interstitial Space CellsCapillaryMedtronic illustration: not to scale. Medtronic6 Diabetes 7. Continuous Glucose Monitoring TechnologyGlucose sensor readings 300every 5 minutes (288/day)REAL-Time Trend Graphsreveal glucose patterns overtimeGlucose mg/dL 200REAL-Time Trend Arrowsshow the direction and rateof glucose level changes 100TargetREAL-Time Alerts can be Zone customized to let peoplewith diabetes know whenthey are out of range. 0Offers three layers ofprotection: Rate-of-Change Alerts 3AM6AM9AM 12PM 3PM 6PM 9PM Predictive Alerts Time of Day Low and High AlertsMedtronic 7* Levetan C, et al. Diabetes Care 2003; 26:1-8Diabetes 8. Personal CGM Alerts Patients to Intervene toAvoid Dangerous High and Low Blood Glucose Fewer highs = less complicationsAlert Alert AlertFewer lows = less accidents, coma, deathMedtronic 8Diabetes 9. Medtronic CareLink Personal ReportsMedtronic 9Diabetes 10. Safety and Comfort: Key Concepts for Success Most important for success.Medtronic 10Diabetes 11. Step 1: Set Low Sensor Glucose AlertLow SG Alert ONLY High SG Alert is OFF60 Alert sounds when SensorGlucose is 60 mg/dl Medtronic11 Diabetes 12. Step 2: Set High Sensor Glucose Alert Turn on High SG Alert30060 Range between High and Low Alerts is WIDE. Focus on safety, while learning how to understand CGM trends.Medtronic 12Diabetes 13. Step 3: Tighten the Sensor Glucose AlertsLow SG Alert is 70 mg/dl High SG Alert is 250 mg/dl25070 High and Low Sensor Glucose Alert thresholds are now closer to target range. Adjust based on individual needs. Medtronic13 Diabetes 14. Step #4: Add High and Low Predictive AlertsPredictive Alerts occurBEFORE the threshold.25070 Optional Alert setting.1:33P HIGH PREDICTED Start with 10 minutes for Predictive Alerts, then adjust as needed.Medtronic 14Diabetes 15. Integrated Insulin Pump with Built-In CGM is the Platform Upon Which the Artificial Pancreas Will Be Built A All Subjects204 MDI MDI 8.5 216 SAPSAP**8.1% * * 8.0%8.0% 7.9% 8.0 A1C (%) ** ** 7.6%7.6% 7.4%7.4%7.4% 7.5 7.3%7.5% 7.5% Study Phase Continuation Phase 7.0 0 36 912 1518MonthMedtronic *, P